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Risk factors for treatment failure with antiosteoporosis medication: the Global Longitudinal Study of Osteoporosis in Women (GLOW)

Risk factors for treatment failure with antiosteoporosis medication: the Global Longitudinal Study of Osteoporosis in Women (GLOW)
Risk factors for treatment failure with antiosteoporosis medication: the Global Longitudinal Study of Osteoporosis in Women (GLOW)
Antiosteoporosis medication (AOM) does not abolish fracture risk, and some individuals experience multiple fractures while on treatment. Therefore, criteria for treatment failure have recently been defined. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), we analyzed risk factors for treatment failure, defined as sustaining two or more fractures while on AOM. GLOW is a prospective, observational cohort study of women aged ?55 years sampled from primary care practices in 10 countries. Self-administered questionnaires collected data on patient characteristics, fracture risk factors, previous fractures, AOM use, and health status. Data were analyzed from women who used the same class of AOM continuously over 3 survey years and had data available on fracture occurrence. Multivariable logistic regression was used to identify independent predictors of treatment failure. Data from 26,918 women were available, of whom 5550 were on AOM. During follow-up, 73 of 5550 women in the AOM group (1.3%) and 123 of 21,368 in the non-AOM group (0.6%) reported occurrence of two or more fractures. The following variables were associated with treatment failure: lower Short Form 36 Health Survey (SF-36) score (physical function and vitality) at baseline, higher Fracture Risk Assessment Tool (FRAX) score, falls in the past 12 months, selected comorbid conditions, prior fracture, current use of glucocorticoids, need of arms to assist to standing, and unexplained weight loss ?10 lb (?4.5?kg). Three variables remained predictive of treatment failure after multivariable analysis: worse SF-36 vitality score (odds ratio [OR] per 10-point increase, 0.85; 95% confidence interval [CI], 0.76–0.95; p?=?0.004); two or more falls in the past year (OR, 2.40; 95% CI, 1.34–4.29; p?=?0.011), and prior fracture (OR, 2.93; 95% CI, 1.81–4.75; p?<?0.0001). The C statistic for the model was 0.712. Specific strategies for fracture prevention should therefore be developed for this subgroup of patients. © 2014 American Society for Bone and Mineral Research.
0884-0431
260-267
Diez-Perez, A.
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Adachi, J.D.
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Adami, S.
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Anderson, F.A.
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Boonen, S.
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Chapurlat, R.
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Compston, J.E.
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Cooper, C.
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Gehlbach, S.H.
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Greenspan, S.L.
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Hooven, F.H.
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Lacroix, A.Z.
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Nieves, J.W.
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Netelenbos, J.C.
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Pfeilschifter, J.
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Rossini, M.
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Roux, C.
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Saag, K.G.
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Silverman, S.
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Siris, E.S.
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Wyman, A.
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Rushton-Smith, S.K.
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Watts, N.B.
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Diez-Perez, A.
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Adachi, J.D.
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Adami, S.
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Anderson, F.A.
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Boonen, S.
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Chapurlat, R.
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Compston, J.E.
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Cooper, C.
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Gehlbach, S.H.
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Greenspan, S.L.
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Hooven, F.H.
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Lacroix, A.Z.
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Nieves, J.W.
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Netelenbos, J.C.
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Pfeilschifter, J.
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Rossini, M.
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Roux, C.
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Saag, K.G.
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Silverman, S.
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Siris, E.S.
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Wyman, A.
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Rushton-Smith, S.K.
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Watts, N.B.
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Diez-Perez, A., Adachi, J.D., Adami, S., Anderson, F.A., Boonen, S., Chapurlat, R., Compston, J.E., Cooper, C., Gehlbach, S.H., Greenspan, S.L., Hooven, F.H., Lacroix, A.Z., Nieves, J.W., Netelenbos, J.C., Pfeilschifter, J., Rossini, M., Roux, C., Saag, K.G., Silverman, S., Siris, E.S., Wyman, A., Rushton-Smith, S.K. and Watts, N.B. (2014) Risk factors for treatment failure with antiosteoporosis medication: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Journal of Bone and Mineral Research, 29 (1), 260-267. (doi:10.1002/jbmr.2023). (PMID:23794198)

Record type: Article

Abstract

Antiosteoporosis medication (AOM) does not abolish fracture risk, and some individuals experience multiple fractures while on treatment. Therefore, criteria for treatment failure have recently been defined. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), we analyzed risk factors for treatment failure, defined as sustaining two or more fractures while on AOM. GLOW is a prospective, observational cohort study of women aged ?55 years sampled from primary care practices in 10 countries. Self-administered questionnaires collected data on patient characteristics, fracture risk factors, previous fractures, AOM use, and health status. Data were analyzed from women who used the same class of AOM continuously over 3 survey years and had data available on fracture occurrence. Multivariable logistic regression was used to identify independent predictors of treatment failure. Data from 26,918 women were available, of whom 5550 were on AOM. During follow-up, 73 of 5550 women in the AOM group (1.3%) and 123 of 21,368 in the non-AOM group (0.6%) reported occurrence of two or more fractures. The following variables were associated with treatment failure: lower Short Form 36 Health Survey (SF-36) score (physical function and vitality) at baseline, higher Fracture Risk Assessment Tool (FRAX) score, falls in the past 12 months, selected comorbid conditions, prior fracture, current use of glucocorticoids, need of arms to assist to standing, and unexplained weight loss ?10 lb (?4.5?kg). Three variables remained predictive of treatment failure after multivariable analysis: worse SF-36 vitality score (odds ratio [OR] per 10-point increase, 0.85; 95% confidence interval [CI], 0.76–0.95; p?=?0.004); two or more falls in the past year (OR, 2.40; 95% CI, 1.34–4.29; p?=?0.011), and prior fracture (OR, 2.93; 95% CI, 1.81–4.75; p?<?0.0001). The C statistic for the model was 0.712. Specific strategies for fracture prevention should therefore be developed for this subgroup of patients. © 2014 American Society for Bone and Mineral Research.

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Published date: January 2014
Organisations: Faculty of Medicine

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Local EPrints ID: 361711
URI: http://eprints.soton.ac.uk/id/eprint/361711
ISSN: 0884-0431
PURE UUID: 68d7ab8c-4a01-4cb0-8b25-81fb69ca38d7
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 04 Feb 2014 14:26
Last modified: 26 Nov 2019 01:58

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Contributors

Author: A. Diez-Perez
Author: J.D. Adachi
Author: S. Adami
Author: F.A. Anderson
Author: S. Boonen
Author: R. Chapurlat
Author: J.E. Compston
Author: C. Cooper ORCID iD
Author: S.H. Gehlbach
Author: S.L. Greenspan
Author: F.H. Hooven
Author: A.Z. Lacroix
Author: J.W. Nieves
Author: J.C. Netelenbos
Author: J. Pfeilschifter
Author: M. Rossini
Author: C. Roux
Author: K.G. Saag
Author: S. Silverman
Author: E.S. Siris
Author: A. Wyman
Author: S.K. Rushton-Smith
Author: N.B. Watts

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